‘Death with dignity' law takes effect with low participation It took more than 20 years of controversy for the nation to allow terminally ill patients who have no chance of recovery to "die with dignity" with the Hospice, Palliative Care and Life-sustaining Treatment Decision-making Law taking effect Sunday.As in many advanced countries such as Switzerland, Belgium, the Netherlands and some states in the U.S., among others, the way for "well-dying" for terminal patients through the suspension of life-prolonging treatment has finally come to Korea. But the law appears to have a long way to go until it can be considered satisfactory.Various statistics and surveys show that every year in Korea about 50,000 terminally ill patients die in pain and more than 90 percent of the elderly oppose medical treatment to keep terminally ill patients alive, such as CPR (cardiopulmonary resuscitation), hemodialysis, the administration of anti-cancer drugs and the use of artificial respirators. A basic and critical problem is the low participation of medical institutions in adopting the new formula, which is not compulsory. Only 60 of them set up ethics committees to review the suspension of life-prolonging treatment as required by law. But the establishment is not mandatory, so most hospitals are shunning creating committees that must be made of more than five people, including a chairman and two or three religious, legal and ethics experts.It's no wonder that most small- and medium-sized hospitals are reluctant to establish such a committee due to the cost and lack of manpower. Even nearly half of the top general hospitals, including Kangbuk Samsung Hospital, are avoiding the practice.The procedures for the long-awaited system are too complicated as seen, for example, in the provision that the Advance Medical Directives (AMD) for relatively healthy patients who want to forego life-sustaining treatment if they are stricken with a terminal illness later, should be signed even by grand grandparents or grandchildren. Adding to this, there are only 49 medical institutions nationwide receiving AMDs.A revision bill has been forwarded to the National Assembly to simplify the procedure. The Assembly should make haste with reviewing the bill to help reduce the pain of terminally ill patients and their families.